<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<title>Insert title here</title>
</head>
<body>
	<center>
		<form>
			<table>
				<tr>
					<td colspan="2" align="center" valign="top"><font size="3"
						face="Arial">Feedback Form :</font></td>
				</tr>
				<tr>
					<td>User Name :</td>
					<td><input type="text" name="Username"></td>
				</tr>
				<tr></tr>
				<tr>
					<td>E-mail Id :</td>
					<td><input type="text" name="email"></td>
				</tr>
				<tr>
					<td>Subject :</td>
					<td><input type="text" name="subject"></td>
				</tr>
				<tr>
					<td valign="top">Comment :</td>
					<td><textarea name="comment" rows="10" cols="50"></textarea></td>
				</tr>
			</table>
		</form>
	</center>
</body>
</html>